*** Mars Given OK On Positional Sleep Apnea Therapy ***

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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mars
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*** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by mars » Mon Oct 24, 2011 9:09 pm

Hi Everybody

As most of you know, I have been experimenting with myself, and using positional sleep apnea therapy for my obstructive sleep apnea (untreated AHi = 41) for some months now. I have given various updates on this, but the information has been polluted by the usual hijacking and misinformation, so no matter what is posted after this, at least my personal experience will be clear

So I am repeating past information, plus more history, so that it is all in one post.

You may want to check the credentials of my Sleep Centre, which I think is one of the best in the Southern Hemisphere, but I have no comparative studies to prove that, just my opinion

http://www.southernhealth.org.au/page/S ... laboratory

The recent study I posted on positional sleep apnea is worth noting -

http://www.antisnoreshirt.com/v/vspfile ... graphy.pdf

In particular their conclusion -
Positional therapy has the potential to be an effective therapy in a significant proportion of patients with sleep apnea. Rigorous outcome studies evaluating the efficacy of this treatment modality are urgently needed in patients with mild-to-moderate sleep apnea.


and a more consumer oriented overview

http://www.ehow.com/about_5183851_posit ... apnea.html

of which I was particularly interested in this paragraph -
According to the experts at the American College of Chest Physicians in an October 2005 issue of "Chest" magazine, as many as 60% of the people with obstructive sleep apnea experience a lowering of symptoms when they slept on their side as opposed to their back. They estimate that as many as 50% of the people that experience sleep apnea could be successfully treated by using positional therapy.


I have done a lot of travelling in my life, usually by what used to be known as hitch-hiking. So I would normally end up at night in a strange place, and I would sleep out. Given that I never had much money, this became my preferred option when travelling. Although my health is not good, I have not given up on the travelling, and carrying a machine around is not really an option for me.

Reading the threads on this Forum I first came across the Nasopharyngeal Airway

http://en.wikipedia.org/wiki/Nasopharyngeal_airway

https://www.youtube.com/watch?v=fR5jsmGg6e8

and the Oropharyngeal Airway

http://en.wikipedia.org/wiki/Oropharyngeal_airway

https://www.youtube.com/watch?v=sVlRylzLor0

https://www.youtube.com/watch?v=xI9Heh5 ... re=related

Now, next to my favourite Animal Aid Opportunity Shop there is a medical equipment shop. So I ordered a Nasopharyngeal Airway in a couple of sizes. I quickly discovered that, for me, it wasn't going to work. Then I tried the Oropharyngeal Airway in a couple of sizes. Now, someone might be able to make this work, but the gag reflex has to be overcome, and whilst I was about to persist I discovered something else.

I knew from my recliner/napping times that I did not desaturate with my body nearly upright, and my head back; and that I did desaturate if my head was forward, or my body more supine.

I also remembered seeing some Forum posts of the head being moved backwards, so opening the throat. This being cited as a possible help in overcoming obstructive sleep apnea. I also knew about this as I have to do it when I get a laryngospasm. So I bought my first soft cervical collar for $8 from the medical equipment shop, and tried it out.

And that was when my experimenting became testing, as using the collar and sleeping on my side meant no desaturations.

So this is the way it has developed -

The starting point is sleeping on my side - all night. I have also wore an oximeter every night since I started this, and the only time the alarm went off is when I have deliberately turned onto my back and fallen asleep again. I no longer do this.

http://www.the-pillow.com.au/more/side_ ... r_more.php

(I think this also has minimised my plmd, but I will have to wait for the full study results to be sure about that.)

and I still use this most of the time - but possibly no longer need to -

http://www.the-pillow.com.au/more/posit ... w_more.php

and, of course, the soft cervical collar - together with a feather pillow -

http://www.nextag.com/soft-cervical-collar/stores-html

http://www.amazon.com/dp/B002674542/ref ... B002674542

http://www.beddingco.com.au/pillows.htm ... 4god13_p-Q

which also has some interesting pillows.

I will add that I no longer use a cervical collar, but advise all those experimenting to start by using one. When using the soft cervical collar I do not use the cervical neck support pillow, I use a feather pillow.

I now use a cervical neck support pillow

http://www.the-pillow.com.au/more/compl ... s_more.php

which keeps my head upright, ( head in the dip and chin resting against the edge,) and serves the same purpose as the soft cervical collar. The pillow has less resistance than the collar, so I believe it is best to use the collar first until one is used to the head being upright in relation to your body when going to sleep.

I am still experimenting with the two inserts, but it works with and without the inserts.

Then, of course, I have my two trusty oximeters - CMS50E and CMC60D.

I was due for this sleep study months ago, and have had to postpone it 4 times due to ill-health. But at last, on Sunday night just past, I had another full diagnostic sleep study at Monash Sleep Centre, using only a cervical collar and thigh wedge support and back wedge.

I do not get to see the Sleep Doctor until the 1st December, but he sent me a message to continue using positional therapy, that I did not need to use the cpap machine.

So there it is. The prescription of cpap machine is easy, it works if successfully applied, and a whole manufacturing and retail industry is supported by it. And I have no argument with that. But for those it does not suit - for whatever reason - taking the steps to find out if positional therapy is for them - may be a step well worth taking

cheers

Mars

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

NEW

Here is the summary of my sleep study. It is for those who are interested in the best treatment for themselves, and are interested in facts.

http://www.imagebam.com/image/a6af30164295734

cheers

Mars
Last edited by mars on Fri Feb 03, 2012 6:14 am, edited 12 times in total.
for an an easier, cheaper and travel-easy sleep apnea treatment :D

http://www.cpaptalk.com/viewtopic/t7020 ... rapy-.html

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Pugsy
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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by Pugsy » Mon Oct 24, 2011 9:15 pm

Congratulations. I am so happy for you. I know this is very welcomed news for you.

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by Julie » Mon Oct 24, 2011 9:28 pm

Fantastic!

You put in a lot of work, a lot of money and a lot of time, but made the case for not necessarily having to use a machine... now if others do the same thing, not skipping steps along the way, you may just see a lot of people becoming free of their machines and hoses and all the rest of it... someone might name the therapy after you!

Better yet, do it yourself - start a website and see what happens.

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by rocklin » Tue Oct 25, 2011 2:10 am

Yes, sometimes you have to pursue a goal with great single-mindedness.

Congrats on finding a solution.

Did you ever consider buying a nighvision video camera, with a time log, and syncing up the sleep-positions, facial grimaces, etc, with your SD card data?
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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by Slinky » Tue Oct 25, 2011 8:23 am

Congratulation, Mars. This couldn't have come about for a nicer or more deserving guy than you!!

Patience, perseverence and a good sense of humor, eh?

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by xenablue » Tue Oct 25, 2011 9:05 am

WOW! Your patience and perseverence has certainly paid off for you - congratulations, Mars!

Cheers,
xena

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by chunkyfrog » Tue Oct 25, 2011 9:26 am

Congrats, mars.
You done good.

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by jamiswolf » Tue Oct 25, 2011 9:28 am

Hi Mars,
Nice job. Wish I were that dedicated,

I did do a little experiment on my own using my PR S! apap. I opened the range to maximun 4-20 and alternately slept on my side or my back.

On my left side, the machine stayed pegged at 4cm. That could mean I need 4cm or it could mean I need less then 4cm while on my left side.

On my back, the apap cranked itself up to around 16cm.

So it's a no-brainer. I never sleep on my back.

An added benefit is that my cpap induced centrals have declined and leaks are so easy to manage.

Like you, I like to travel and I'm hoping with a little more observation, monitoring, Vit D3, weight loss and Didgeridoo playing...that I may be able to wean from cpap altogether.
Cheers,
Jamis

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by davelikesbeer » Tue Oct 25, 2011 11:13 am

Congratulations!

I think you are very fortunate to have a doctor who trusts you as a patient. Doctors have to deal with all sorts of personalities, ranging from hypochondriacs to people like you who are "expert" patients for lack of a better term. With respect to sleep apnea, I think just about anyone on this forum who tracks their AHI on a regular basis, then follows up when they see changes would be considered an expert. But you really go the extra mile and I think there are so many doctors who would just discard a lot of data you carefully collected in order to treat you like the average patient. I hope things continue to work out for you.

Dave.

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by rocklin » Tue Oct 25, 2011 4:45 pm

davelikesbeer wrote:Doctors have to deal with . . . people like you who are "expert" patients
When they finally accept that you know more about "you and SDB", the difference in their attitude can make your jaw drop.
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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by SleepingUgly » Tue Oct 25, 2011 6:37 pm

I also remembered seeing some Forum posts of the head being moved backwards, so opening the throat. This being cited as a possible help in overcoming obstructive sleep apnea.
Can you clarify the neck/head position? Do you mean back (e.g., chin pointing up), or do you just mean head straight, such as in the link you sent here:

http://www.amazon.com/dp/B002674542/ref ... B002674542
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mars
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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by mars » Tue Oct 25, 2011 7:11 pm

SleepingUgly wrote:
I also remembered seeing some Forum posts of the head being moved backwards, so opening the throat. This being cited as a possible help in overcoming obstructive sleep apnea.


Can you clarify the neck/head position? Do you mean back (e.g., chin pointing up), or do you just mean head straight, such as in the link you sent here:

http://www.amazon.com/dp/B002674542/ref ... B002674542


Hi SU

The link is good. The collar needs to be a good fit, so that the chin does not creep down inside the front of the collar. So I would say that a tight but workable fit is needed.

The idea is to move your chin up so that your head is erect in relation to your body, and as the natural tendency (I think) when lying on your side ready to go to sleep is to tuck your head in, then to get your head erect needs some effort. The soft cervical does does all the work for you.

There is an very interesting thread on this at -

viewtopic.php?f=1&t=38929&st=0&sk=t&sd=a&hilit=neck

which will give you more.

cheers

Mars
for an an easier, cheaper and travel-easy sleep apnea treatment :D

http://www.cpaptalk.com/viewtopic/t7020 ... rapy-.html

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by GumbyCT » Tue Oct 25, 2011 9:15 pm

I sleep on my left side, always, with my BiPap auto turned ON to 18/15

That is as positional as I will get.

Oh and a pillow tucked up under my chin.

TMI

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mars
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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by mars » Wed Oct 26, 2011 8:26 am

Hi Everybody

I see that JNK is still trying to mislead us about Positional Sleep Apnea Therapy -

viewtopic/t70222/viewtopic.php?f=1&t=70 ... 93#p649893

Pity - but there seems to be no end to his obsession .

I would also mention that the Mayo Clinic appears to be ignorant of the latest aids that make Positional Sleep Apnea Therapy so much easier to be applied successfully. Aids such as the cervical collar, the thigh cushion and knee positioner, and the memory foam cervical neck support pillowy. All of which which makes me wonder how much they really looked at Positional Therapy for OSA, rather than just reiterate old stuff.

cheers

Mars
for an an easier, cheaper and travel-easy sleep apnea treatment :D

http://www.cpaptalk.com/viewtopic/t7020 ... rapy-.html

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Re: *** Mars Given OK On Positional Sleep Apnea Therapy ***

Post by drdrew » Wed Oct 26, 2011 12:04 pm

i certainly believe i fall into this category. after my sleep study i was prescribed an ASV machine. this was because of my centrals. i remember in the sleep study the kept on having to put me on my back for testing. at home i have now gone down to straight cpap. right around 6-8 pressure, NO CENTRALS. i read my data weekly and i can see clusters on occasional nights where i must turn onto my back for 30 minutes, the pressure spikes up, i have a bunch of OSA events, and usually the mask starts leaking and it wakes me up!

but most nights i stay on my side. i suppose a simple tennis ball sewn into the back of the shirt could keep you on your side....but after 15 years of my wife yelling "roll over" i am pretty well trained!!!

i would be interested in more comfortable alternatives to the tennis ball...like a wedge...i will follow your threads.

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